<div style="width:1000px; float:none;margin:0 auto;padding-top:50px;text-align:left;">
  <div class="fleft padr20" style="width:670px;">
    <div style="position:relative;width:670px">
      <div class="step-line">&nbsp;</div>
      <div class="step-arw-pos" style="left:0px;"><img src="#" width="83" height="10" border="0" alt=""></div>
      <div class="step-arw-pos" style="left:150px;"><img src="#" width="83" height="10" border="0" alt=""></div>
      <div class="fleft txt-center" style="padding-right:74px;">
        <div class="mediumhdrtxt boldtxt padb20" style="color:#F8B107">STEP 1</div>
        <div class="smalltxt clr6 padl5">BASIC DETAILS</div>
      </div>
      <!--			<div class="fleft txt-center" style="padding-right:75px;">
				<div class="mediumhdrtxt boldtxt padb20 clr8">STEP 2</div>
				<div class="smalltxt clr5">PROFILE DETAILS</div>
			</div>		-->
      <br clear="all">
    </div>
    <div class="padt20">
      <!--  -->
    </div>
    <!-- Form Starts -->
    <div id="frm">
      <div style="padding-top:10px;" class="bigtxt-s clr4">Register and find your life partner</div>
      <div class="mediumtxt clr1 padt4 padb15">Take the first step in finding your soulmate by providing your basic information. It's simple and easy. </div>
      <div class="curve2" style="background:#e6e6e6;padding:3px;margin-bottom:10px;">
        <div class="fleft mediumtxt boldtxt padl5 padt1" style="font-size:13px;">Basic Details</div>
        <div class="fright smalltxt padr5">Fields marked in ' <span class="rdclr">*</span> ' are Mandatory <?php echo validation_errors(); ?></div>
        <div class="clear">
          <!-- -->
        </div>
      </div>
      <div style="width:560px;">
        <form name="register" method="post" action="">
          <!-- communitymatrimony list -->
          <!-- Profile created by -->
          <dl>
            <dt class="frmlabel">
              <label for="">Profile created by <span class="rdclr">*</span></label>
            </dt>
            <dd>
            
              <?php echo $html_actcreatedby;?>
              <div class="error"><?php echo $error_profile;?></div>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- Name and tooltip content -->
          <!-- FNAME -->
          <dl>
            <dt class="frmlabel">
              <label for="cname">First Name <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <input type="text" maxlength="40" class="input" id="fname" name="fname" value="<?php echo $fname;?>" tabindex="6" style="width:167px;">
              <div class="error"><?php echo $error_fname;?></div>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- LNAME -->
          <dl>
            <dt class="frmlabel">
              <label for="cname">Last Name <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <input type="text" maxlength="40" class="input" id="lname" name="lname" value="<?php echo $lname;?>" tabindex="6" style="width:167px;">
              <div class="error"><?php echo $error_lname;?></div>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- Gender -->
          <dl id="gender_div">
            <dt class="frmlabel">
              <label for="">Gender <span class="rdclr">*</span></label>
            </dt>
            <dd style="padding:8px 0 12px 10px;">
             <?php /*?> <input  type="radio" class="radiomargin gender_valid" tabindex="7" name="gender"
			   <?php if($_POST['gender']==1) echo 'checked="checked"'; ?> id="gendermale" value="1"><?php */?>
              <!---->
			  <input type="radio" name="gender" value="1" <?php echo set_radio('gender', '1')?> /> 
			  <label class="radiolabel" for="gendermale">Male</label>
			   <input type="radio" name="gender" value="2" <?php echo set_radio('gender', '2')?> /> 
			    <label class="radiolabel" for="genderfemale" id="female_lbl">Female</label>
			  
            <?php /*?>  <input  type="radio" class="radiomargin gender_valid" tabindex="8" name="gender" 
			    <?php if($_POST['gender']==2) echo 'checked="checked"'; ?> value="2" id="genderfemale"><?php */?>
            
              <div class="error"><?php echo $error_gender;?></div>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- Date of birth  -->
          <dl>
            <dt class="frmlabel">
              <label for="AGE">Date of birth <span class="rdclr">*</span></label>
            </dt>
            <dd id="">
              <select class="selectfield" id="day" name="day"  style="width: 70px;" tabindex="9">
                <option value="" selected="">-Date-</option>
                <option value="1" selected="selected">1</option>
                <option value="2">2</option>
                <option value="3">3</option>
                <option value="4">4</option>
                <option value="5">5</option>
                <option value="6">6</option>
                <option value="7">7</option>
                <option value="8">8</option>
                <option value="9">9</option>
                <option value="10">10</option>
                <option value="11">11</option>
                <option value="12">12</option>
                <option value="13">13</option>
                <option value="14">14</option>
                <option value="15">15</option>
                <option value="16">16</option>
                <option value="17">17</option>
                <option value="18">18</option>
                <option value="19">19</option>
                <option value="20">20</option>
                <option value="21">21</option>
                <option value="22">22</option>
                <option value="23">23</option>
                <option value="24">24</option>
                <option value="25">25</option>
                <option value="26">26</option>
                <option value="27">27</option>
                <option value="28">28</option>
                <option value="29">29</option>
                <option value="30">30</option>
                <option value="31">31</option>
              </select>
              <select class="selectfield" id="month" name="month" style="width: 95px;" tabindex="10">
                <option value="" selected="">-Month-</option>
                <option value="01" selected="selected">January</option>
                <option value="02">February</option>
                <option value="03">March</option>
                <option value="04">April</option>
                <option value="05">May</option>
                <option value="06">June</option>
                <option value="07">July</option>
                <option value="08">August</option>
                <option value="09">September</option>
                <option value="10">October</option>
                <option value="11">November</option>
                <option value="12">December</option>
              </select>
              <span id="YearGenderDivId">
              <select class="selectfield" id="year" name="year" style="width: 70px;" tabindex="11">
                <option value="" selected="">-Year-</option>
                <option value="1995" selected="selected">1995</option>
                <option value="1994">1994</option>
                <option value="1993">1993</option>
                <option value="1992">1992</option>
                <option value="1991">1991</option>
                <option value="1990">1990</option>
                <option value="1989">1989</option>
                <option value="1988">1988</option>
                <option value="1987">1987</option>
                <option value="1986">1986</option>
                <option value="1985">1985</option>
                <option value="1984">1984</option>
                <option value="1983">1983</option>
                <option value="1982">1982</option>
                <option value="1981">1981</option>
                <option value="1980">1980</option>
                <option value="1979">1979</option>
                <option value="1978">1978</option>
                <option value="1977">1977</option>
                <option value="1976">1976</option>
                <option value="1975">1975</option>
                <option value="1974">1974</option>
                <option value="1973">1973</option>
                <option value="1972">1972</option>
                <option value="1971">1971</option>
                <option value="1970">1970</option>
                <option value="1969">1969</option>
                <option value="1968">1968</option>
                <option value="1967">1967</option>
                <option value="1966">1966</option>
                <option value="1965">1965</option>
                <option value="1964">1964</option>
                <option value="1963">1963</option>
                <option value="1962">1962</option>
                <option value="1961">1961</option>
                <option value="1960">1960</option>
                <option value="1959">1959</option>
                <option value="1958">1958</option>
                <option value="1957">1957</option>
                <option value="1956">1956</option>
                <option value="1955">1955</option>
                <option value="1954">1954</option>
                <option value="1953">1953</option>
                <option value="1952">1952</option>
                <option value="1951">1951</option>
                <option value="1950">1950</option>
                <option value="1949">1949</option>
                <option value="1948">1948</option>
                <option value="1947">1947</option>
                <option value="1946">1946</option>
                <option value="1945">1945</option>
                <option value="1944">1944</option>
                <option value="1943">1943</option>
              </select>
              </span>
              <div id="dobErrMsg" for="DateofBirth" class="errorhighlight padt3"><?php 
              	if($error_day)
              			echo $error_day;
              	else if($error_month)
              		echo $error_month;
              	else
              		echo $error_year;?></div>
            </dd>
          </dl>
		  <!-- height-->
		   <dl>
            <dt>
              <label for="heightFeet" style="display:block;">Height <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <select name="heightFeet" id="heightFeet" class="txtBox input" tabindex="7" style="width: 176px; border: 1px solid rgb(213, 213, 213);">
                <option value="0" title="--- Feet/Inches ---" alt="--- Feet/Inches ---">--- Feet/Inches ---</option>
                <option value="121.92 " selected="selected" title="4 feet" alt="4 feet">4 feet</option>
                <option value="124.46" title="4 feet 1 inches" alt="4 feet 1 inches">4 feet 1 inches</option>
                <option value="127.00" title="4 feet 2 inches" alt="4 feet 2 inches">4 feet 2 inches</option>
                <option value="129.54" title="4 feet 3 inches" alt="4 feet 3 inches">4 feet 3 inches</option>
                <option value="132.08" title="4 feet 4 inches" alt="4 feet 4 inches">4 feet 4 inches</option>
                <option value="134.62" title="4 feet 5 inches" alt="4 feet 5 inches">4 feet 5 inches</option>
                <option value="137.16" title="4 feet 6 inches" alt="4 feet 6 inches">4 feet 6 inches</option>
                <option value="139.70" title="4 feet 7 inches" alt="4 feet 7 inches">4 feet 7 inches</option>
                <option value="142.24" title="4 feet 8 inches" alt="4 feet 8 inches">4 feet 8 inches</option>
                <option value="144.78" title="4 feet 9 inches" alt="4 feet 9 inches">4 feet 9 inches</option>
                <option value="147.32" title="4 feet 10 inches" alt="4 feet 10 inches">4 feet 10 inches</option>
                <option value="149.86" title="4 feet 11 inches" alt="4 feet 11 inches">4 feet 11 inches</option>
                <option value="152.40" title="5 feet" alt="5 feet">5 feet</option>
                <option value="154.94" title="5 feet 1 inches" alt="5 feet 1 inches">5 feet 1 inches</option>
                <option value="157.48" title="5 feet 2 inches" alt="5 feet 2 inches">5 feet 2 inches</option>
                <option value="160.02" title="5 feet 3 inches" alt="5 feet 3 inches">5 feet 3 inches</option>
                <option value="162.56" title="5 feet 4 inches" alt="5 feet 4 inches">5 feet 4 inches</option>
                <option value="165.10" title="5 feet 5 inches" alt="5 feet 5 inches">5 feet 5 inches</option>
                <option value="167.64" title="5 feet 6 inches" alt="5 feet 6 inches">5 feet 6 inches</option>
                <option value="170.18" title="5 feet 7 inches" alt="5 feet 7 inches">5 feet 7 inches</option>
                <option value="172.72" title="5 feet 8 inches" alt="5 feet 8 inches">5 feet 8 inches</option>
                <option value="175.26" title="5 feet 9 inches" alt="5 feet 9 inches">5 feet 9 inches</option>
                <option value="177.80" title="5 feet 10 inches" alt="5 feet 10 inches">5 feet 10 inches</option>
                <option value="180.34" title="5 feet 11 inches" alt="5 feet 11 inches">5 feet 11 inches</option>
                <option value="182.88" title="6 feet" alt="6 feet">6 feet</option>
                <option value="185.42" title="6 feet 1 inches" alt="6 feet 1 inches">6 feet 1 inches</option>
                <option value="187.96" title="6 feet 2 inches" alt="6 feet 2 inches">6 feet 2 inches</option>
                <option value="190.50" title="6 feet 3 inches" alt="6 feet 3 inches">6 feet 3 inches</option>
                <option value="193.04" title="6 feet 4 inches" alt="6 feet 4 inches">6 feet 4 inches</option>
                <option value="195.58" title="6 feet 5 inches" alt="6 feet 5 inches">6 feet 5 inches</option>
                <option value="198.12" title="6 feet 6 inches" alt="6 feet 6 inches">6 feet 6 inches</option>
                <option value="200.66" title="6 feet 7 inches" alt="6 feet 7 inches">6 feet 7 inches</option>
                <option value="203.20" title="6 feet 8 inches" alt="6 feet 8 inches">6 feet 8 inches</option>
                <option value="205.74" title="6 feet 9 inches" alt="6 feet 9 inches">6 feet 9 inches</option>
                <option value="208.28" title="6 feet 10 inches" alt="6 feet 10 inches">6 feet 10 inches</option>
                <option value="210.82" title="6 feet 11 inches" alt="6 feet 11 inches">6 feet 11 inches</option>
                <option value="213.36" title="7 feet" alt="7 feet">7 feet</option>
                <option value="215.90" title="7 feet 1 inches" alt="7 feet 1 inches">7 feet 1 inches</option>
                <option value="218.44" title="7 feet 2 inches" alt="7 feet 2 inches">7 feet 2 inches</option>
                <option value="220.98" title="7 feet 3 inches" alt="7 feet 3 inches">7 feet 3 inches</option>
                <option value="223.52" title="7 feet 4 inches" alt="7 feet 4 inches">7 feet 4 inches</option>
                <option value="226.06" title="7 feet 5 inches" alt="7 feet 5 inches">7 feet 5 inches</option>
                <option value="228.60" title="7 feet 6 inches" alt="7 feet 6 inches">7 feet 6 inches</option>
                <option value="231.14" title="7 feet 7 inches" alt="7 feet 7 inches">7 feet 7 inches</option>
                <option value="233.68" title="7 feet 8 inches" alt="7 feet 8 inches">7 feet 8 inches</option>
                <option value="236.22" title="7 feet 9 inches" alt="7 feet 9 inches">7 feet 9 inches</option>
                <option value="238.76" title="7 feet 10 inches" alt="7 feet 10 inches">7 feet 10 inches</option>
                <option value="241.30" title="7 feet 11 inches" alt="7 feet 11 inches">7 feet 11 inches</option>
              </select>
              <div class="error"><?php echo $error_heightFeet;?></div>
            </dd>
          </dl>
          <!-- Marital Status  -->
          <span id="maritalStatusDivId">
          <!--MARITAL STATUS-->
          <dl class="dotted">
          </dl>
          <dl>
            <dt class="frmlabel">
              <label for="">Marital status <span class="rdclr">*</span></label>
            </dt>
            <dd style="padding:8px 0 12px 10px;">
             <?php echo $html_maritalstatus; ?>
              <span id="maritalspan" class="errortxt"><?php echo $error_maritalStatus; ?></span> </dd>
          </dl>
          <!--MARITAL STATUS-->
          </span>
          <!-- appearence  -->
          <span id="appearanceDiv">
          <!--APPEARENCE-->
          <input type="hidden" name="appearancefeature" value="0">
          <!--APPEARENCE-->
          </span>
          <!-- culturalBackground  -->
          <span id="culturalBackground">
          <!--RELIGION-->
          <dl class="dotted">
          </dl>
          <dl>
            <dt id="denomlbl" class="frmlabel">
              <label for="">Religion <span class="rdclr"> *</span></label>
            </dt>
            <dd>
              <select id="denomination" name="denomination" style="width:173px;" tabindex="20">
                <option value="0" selected="" title="--- Select ---" alt="--- Select ---">--- Select ---</option>
                <option value="12" title="Catholic" alt="Catholic">Catholic</option>
                <option value="20" title="Latin Catholic" alt="Latin Catholic">Latin Catholic</option>
                <option value="35" title="Syrian Catholic" alt="Syrian Catholic">Syrian Catholic</option>
                <option value="34" title="Syro Malabar" alt="Syro Malabar">Syro Malabar</option>
                <option value="23" title="Malankara" alt="Malankara">Malankara</option>
                <option value="29" title="Orthodox" alt="Orthodox">Orthodox</option>
                <option value="17" title="Jacobite" alt="Jacobite">Jacobite</option>
                <option value="24" title="Marthoma" alt="Marthoma">Marthoma</option>
                <option value="14" title="Church of South India (CSI)" alt="Church of South India (CSI)">Church of South India (CSI)</option>
                <option value="31" title="Protestant" alt="Protestant">Protestant</option>
                <option value="30" title="Pentecostal" alt="Pentecostal">Pentecostal</option>
                <option value="9" title="Born Again" alt="Born Again">Born Again</option>
                <option value="10" title="Brethren" alt="Brethren">Brethren</option>
                <option value="16" title="Evangelical" alt="Evangelical">Evangelical</option>
                <option value="7" title="Assembly of God (AG)" alt="Assembly of God (AG)">Assembly of God (AG)</option>
                <option value="13" title="Church of God" alt="Church of God">Church of God</option>
                <option value="8" title="Baptist" alt="Baptist">Baptist</option>
                <option value="3" title="Adventist" alt="Adventist">Adventist</option>
                <option value="36" title="Seventh-day Adventist" alt="Seventh-day Adventist">Seventh-day Adventist</option>
                <option value="4" title="Anglican / Episcopal" alt="Anglican / Episcopal">Anglican / Episcopal</option>
                <option value="37" title="Jehovah`s Witnesses" alt="Jehovah`s Witnesses">Jehovah`s Witnesses</option>
                <option value="27" title="Methodist" alt="Methodist">Methodist</option>
                <option value="6" title="Assyrian" alt="Assyrian">Assyrian</option>
                <option value="22" title="Lutheran" alt="Lutheran">Lutheran</option>
                <option value="19" title="Jewish" alt="Jewish">Jewish</option>
                <option value="26" title="Mennonite" alt="Mennonite">Mennonite</option>
                <option value="11" title="Calvinist" alt="Calvinist">Calvinist</option>
                <option value="15" title="Congregational" alt="Congregational">Congregational</option>
                <option value="32" title="Presbyterian" alt="Presbyterian">Presbyterian</option>
                <option value="21" title="Latter day saints" alt="Latter day saints">Latter day saints</option>
                <option value="9997" title="Not in the list" alt="Not in the list">Not in the list</option>
              </select>
              <span id="denominationDivText" style="display:none;">
              </span> <span id="denominationspan"></span> </dd>
          </dl>
          <!--RELIGION-->
          <!--DENOMINATION-->
			
          <dl class="dotted">
          </dl>
          <dl>
            <dt id="denomlbl" class="frmlabel">
              <label for="">Denomination <span class="rdclr"> *</span></label>
            </dt>
            <dd>
              <select id="denomination" name="denomination" style="width:173px;" tabindex="20">
                <option value="0" selected="" title="--- Select ---" alt="--- Select ---">--- Select ---</option>
                <option value="12" title="Catholic" alt="Catholic">Catholic</option>
                <option value="20" title="Latin Catholic" alt="Latin Catholic">Latin Catholic</option>
                <option value="35" title="Syrian Catholic" alt="Syrian Catholic">Syrian Catholic</option>
                <option value="34" title="Syro Malabar" alt="Syro Malabar">Syro Malabar</option>
                <option value="23" title="Malankara" alt="Malankara">Malankara</option>
                <option value="29" title="Orthodox" alt="Orthodox">Orthodox</option>
                <option value="17" title="Jacobite" alt="Jacobite">Jacobite</option>
                <option value="24" title="Marthoma" alt="Marthoma">Marthoma</option>
                <option value="14" title="Church of South India (CSI)" alt="Church of South India (CSI)">Church of South India (CSI)</option>
                <option value="31" title="Protestant" alt="Protestant">Protestant</option>
                <option value="30" title="Pentecostal" alt="Pentecostal">Pentecostal</option>
                <option value="9" title="Born Again" alt="Born Again">Born Again</option>
                <option value="10" title="Brethren" alt="Brethren">Brethren</option>
                <option value="16" title="Evangelical" alt="Evangelical">Evangelical</option>
                <option value="7" title="Assembly of God (AG)" alt="Assembly of God (AG)">Assembly of God (AG)</option>
                <option value="13" title="Church of God" alt="Church of God">Church of God</option>
                <option value="8" title="Baptist" alt="Baptist">Baptist</option>
                <option value="3" title="Adventist" alt="Adventist">Adventist</option>
                <option value="36" title="Seventh-day Adventist" alt="Seventh-day Adventist">Seventh-day Adventist</option>
                <option value="4" title="Anglican / Episcopal" alt="Anglican / Episcopal">Anglican / Episcopal</option>
                <option value="37" title="Jehovah`s Witnesses" alt="Jehovah`s Witnesses">Jehovah`s Witnesses</option>
                <option value="27" title="Methodist" alt="Methodist">Methodist</option>
                <option value="6" title="Assyrian" alt="Assyrian">Assyrian</option>
                <option value="22" title="Lutheran" alt="Lutheran">Lutheran</option>
                <option value="19" title="Jewish" alt="Jewish">Jewish</option>
                <option value="26" title="Mennonite" alt="Mennonite">Mennonite</option>
                <option value="11" title="Calvinist" alt="Calvinist">Calvinist</option>
                <option value="15" title="Congregational" alt="Congregational">Congregational</option>
                <option value="32" title="Presbyterian" alt="Presbyterian">Presbyterian</option>
                <option value="21" title="Latter day saints" alt="Latter day saints">Latter day saints</option>
                <option value="9997" title="Not in the list" alt="Not in the list">Not in the list</option>
              </select>
              <span id="denominationDivText" style="display:none;">
              </span> <span id="denominationspan"></span> </dd>
          </dl>
          <!--DENOMINATION-->
          <!--CASTE-->
          <dl class="dotted">
          </dl>
          <dl id="casteDivId">
            <dt class="branchDiv">
              <label for="">Diocese<span class="rdclr"> *</span></label>
            </dt>
            <dd>
              <select style="width:173px;" tabindex="21" name="caste" id="caste">
                <option value="0" selected="" title="--- Select ---" alt="--- Select ---">--- Select ---</option>
                <option value="3001" title="Alleppey Diocese" alt="Alleppey Diocese">Alleppey Diocese</option>
                <option value="3002" title="Bathery Diocese" alt="Bathery Diocese">Bathery Diocese</option>
                <option value="3003" title="Calicut Diocese" alt="Calicut Diocese">Calicut Diocese</option>
                <option value="3004" title="Changanacherry Archdiocese" alt="Changanacherry Archdiocese">Changanacherry Archdiocese</option>
                <option value="3005" title="Cochin Diocese" alt="Cochin Diocese">Cochin Diocese</option>
                <option value="3006" title="Coimbatore Diocese" alt="Coimbatore Diocese">Coimbatore Diocese</option>
                <option value="3007" title="Ernakulam-Angamaly Major Archdiocese" alt="Ernakulam-Angamaly Major Archdiocese">Ernakulam-Angamaly Major Archdiocese</option>
                <option value="3008" title="Idukki Diocese " alt="Idukki Diocese ">Idukki Diocese </option>
                <option value="3009" title="Irinjalakuda Diocese" alt="Irinjalakuda Diocese">Irinjalakuda Diocese</option>
                <option value="3010" title="Kanjirappally Diocese" alt="Kanjirappally Diocese">Kanjirappally Diocese</option>
                <option value="3011" title="Kannur Diocese" alt="Kannur Diocese">Kannur Diocese</option>
                <option value="3012" title="Kothamangalam Diocese" alt="Kothamangalam Diocese">Kothamangalam Diocese</option>
                <option value="3013" title="Kottapuram Diocese" alt="Kottapuram Diocese">Kottapuram Diocese</option>
                <option value="3014" title="Kottayam Archdiocese" alt="Kottayam Archdiocese">Kottayam Archdiocese</option>
                <option value="3015" title="Mananthavady Diocese" alt="Mananthavady Diocese">Mananthavady Diocese</option>
                <option value="3016" title="Mavelikara Diocese" alt="Mavelikara Diocese">Mavelikara Diocese</option>
                <option value="3017" title="Muvattupuzha Diocese" alt="Muvattupuzha Diocese">Muvattupuzha Diocese</option>
                <option value="3018" title="Neyyattinkara Diocese" alt="Neyyattinkara Diocese">Neyyattinkara Diocese</option>
                <option value="3019" title="Palai Diocese" alt="Palai Diocese">Palai Diocese</option>
                <option value="3020" title="Palghat Diocese" alt="Palghat Diocese">Palghat Diocese</option>
                <option value="3021" title="Pathanamthitta Diocese" alt="Pathanamthitta Diocese">Pathanamthitta Diocese</option>
                <option value="3022" title="Punalur Diocese" alt="Punalur Diocese">Punalur Diocese</option>
                <option value="3023" title="Quilon Diocese" alt="Quilon Diocese">Quilon Diocese</option>
                <option value="3024" title="Tellicherry Archdiocese" alt="Tellicherry Archdiocese">Tellicherry Archdiocese</option>
                <option value="3025" title="Thamarassery Diocese" alt="Thamarassery Diocese">Thamarassery Diocese</option>
                <option value="3026" title="Tiruvalla Archdiocese" alt="Tiruvalla Archdiocese">Tiruvalla Archdiocese</option>
                <option value="3027" title="Trichur Archdiocese" alt="Trichur Archdiocese">Trichur Archdiocese</option>
                <option value="3028" title="Trivandrum Archdiocese" alt="Trivandrum Archdiocese">Trivandrum Archdiocese</option>
                <option value="3029" title="Trivandrum Major Archdiocese" alt="Trivandrum Major Archdiocese">Trivandrum Major Archdiocese</option>
                <option value="3030" title="Verapoly Archdiocese" alt="Verapoly Archdiocese">Verapoly Archdiocese</option>
                <option value="3031" title="Vijayapuram Diocese" alt="Vijayapuram Diocese">Vijayapuram Diocese</option>
                <option value="9997" title="Others" alt="Others">Others</option>
              </select>
              <span id="casteDivText" style="display:none;">
              <input type="text" id="casteOthers" name="casteOthers" size="16" class="input" value="" tabindex="22">
              </span> <span id="castespan"></span> </dd>
          </dl>
          <!--CASTE-->
          </span>
          <!-- MotherTongue  -->
          <span id="MotherTongueDivId">
          <!--MOTHER TONGUE-->
          <input type="hidden" name="mothertonguefeature" value="1">
          <input type="hidden" name="motherTongueOption" value="1">
          <dl class="dotted">
          </dl>
          <dl>
            <dt class="frmlabel" id="mtonglbl">
              <label for="">Mother tongue<span class="rdclr"> *</span></label>
            </dt>
            <dd>
             
             <select name="mother_tongue"><?php echo $mother_tongue; ?></select> <span id="mothertonguespan" class="errortxt"></span></dd>
          </dl>
          <!--MOTHER TONGUE-->
          </span>
          <dl class="dotted">
          </dl>
          <!-- Country  -->
          <dl>
            <dt class="frmlabel">
              <label for="">Country Living In <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <select onchange="selectCountryCode(this.value);" id="country" name="living_country" tabindex="25" style="width:175px;">
              
              <?php echo $country_living;?>
               <!-- <option value="0">--- Select ---</option>
                <option value="98">India</option>
                <option value="222">United States of America</option>
                <option value="220">United Arab Emirates</option>
                <option value="129">Malaysia</option>
                <option value="221">United Kingdom</option>
                <option value="13">Australia</option>
                <option value="185">Saudi Arabia</option>
                <option value="39">Canada</option>
                <option value="189">Singapore</option>
                <option value="114">Kuwait</option>
                <option value="">-------------------------</option>
                <option value="1" title="Afghanistan" alt="Afghanistan">Afghanistan</option>
                <option value="2" title="Albania" alt="Albania">Albania</option>
                <option value="3" title="Algeria" alt="Algeria">Algeria</option>
                <option value="4" title="American Samoa" alt="American Samoa">American Samoa</option>
                <option value="5" title="Andorra" alt="Andorra">Andorra</option>
                <option value="6" title="Angola" alt="Angola">Angola</option>
                <option value="7" title="Anguilla" alt="Anguilla">Anguilla</option>
                <option value="8" title="Antarctica" alt="Antarctica">Antarctica</option>
                <option value="9" title="Antigua and Barbuda" alt="Antigua and Barbuda">Antigua and Barbuda</option>
                <option value="10" title="Argentina" alt="Argentina">Argentina</option>
                <option value="11" title="Armenia" alt="Armenia">Armenia</option>
                <option value="12" title="Aruba" alt="Aruba">Aruba</option>
                <option value="13" title="Australia" alt="Australia">Australia</option>
                <option value="14" title="Austria" alt="Austria">Austria</option>
                <option value="15" title="Azerbaijan" alt="Azerbaijan">Azerbaijan</option>
                <option value="16" title="Bahamas" alt="Bahamas">Bahamas</option>
                <option value="17" title="Bahrain" alt="Bahrain">Bahrain</option>
                <option value="18" title="Bangladesh" alt="Bangladesh">Bangladesh</option>
                <option value="19" title="Barbados" alt="Barbados">Barbados</option>
                <option value="20" title="Belarus" alt="Belarus">Belarus</option>
                <option value="21" title="Belgium" alt="Belgium">Belgium</option>
                <option value="22" title="Belize" alt="Belize">Belize</option>
                <option value="23" title="Benin" alt="Benin">Benin</option>
                <option value="24" title="Bermuda" alt="Bermuda">Bermuda</option>
                <option value="25" title="Bhutan" alt="Bhutan">Bhutan</option>
                <option value="26" title="Bolivia" alt="Bolivia">Bolivia</option>
                <option value="27" title="Bosnia and Herzegovina" alt="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
                <option value="28" title="Botswana" alt="Botswana">Botswana</option>
                <option value="29" title="Bouvet Island" alt="Bouvet Island">Bouvet Island</option>
                <option value="30" title="Brazil" alt="Brazil">Brazil</option>
                <option value="31" title="British Indian Ocean Territory" alt="British Indian Ocean Territory">British Indian Ocean Territory</option>
                <option value="32" title="British Virgin Islands" alt="British Virgin Islands">British Virgin Islands</option>
                <option value="33" title="Brunei" alt="Brunei">Brunei</option>
                <option value="34" title="Bulgaria" alt="Bulgaria">Bulgaria</option>
                <option value="35" title="Burkina Faso" alt="Burkina Faso">Burkina Faso</option>
                <option value="36" title="Burundi" alt="Burundi">Burundi</option>
                <option value="37" title="Cambodia" alt="Cambodia">Cambodia</option>
                <option value="38" title="Cameroon" alt="Cameroon">Cameroon</option>
                <option value="39" title="Canada" alt="Canada">Canada</option>
                <option value="40" title="Cape Verde" alt="Cape Verde">Cape Verde</option>
                <option value="41" title="Cayman Islands" alt="Cayman Islands">Cayman Islands</option>
                <option value="42" title="Central African Republic" alt="Central African Republic">Central African Republic</option>
                <option value="43" title="Chad" alt="Chad">Chad</option>
                <option value="44" title="Chile" alt="Chile">Chile</option>
                <option value="45" title="China" alt="China">China</option>
                <option value="46" title="Christmas Island" alt="Christmas Island">Christmas Island</option>
                <option value="47" title="Cocos Islands" alt="Cocos Islands">Cocos Islands</option>
                <option value="48" title="Colombia" alt="Colombia">Colombia</option>
                <option value="49" title="Comoros" alt="Comoros">Comoros</option>
                <option value="50" title="Congo" alt="Congo">Congo</option>
                <option value="51" title="Cook Islands" alt="Cook Islands">Cook Islands</option>
                <option value="52" title="Costa Rica" alt="Costa Rica">Costa Rica</option>
                <option value="53" title="Croatia" alt="Croatia">Croatia</option>
                <option value="54" title="Cuba" alt="Cuba">Cuba</option>
                <option value="55" title="Cyprus" alt="Cyprus">Cyprus</option>
                <option value="56" title="Czech Republic" alt="Czech Republic">Czech Republic</option>
                <option value="57" title="Denmark" alt="Denmark">Denmark</option>
                <option value="58" title="Djibouti" alt="Djibouti">Djibouti</option>
                <option value="59" title="Dominica" alt="Dominica">Dominica</option>
                <option value="60" title="Dominican Republic" alt="Dominican Republic">Dominican Republic</option>
                <option value="61" title="East Timor" alt="East Timor">East Timor</option>
                <option value="62" title="Ecuador" alt="Ecuador">Ecuador</option>
                <option value="63" title="Egypt" alt="Egypt">Egypt</option>
                <option value="64" title="El Salvador" alt="El Salvador">El Salvador</option>
                <option value="65" title="Equatorial Guinea" alt="Equatorial Guinea">Equatorial Guinea</option>
                <option value="66" title="Eritrea" alt="Eritrea">Eritrea</option>
                <option value="67" title="Estonia" alt="Estonia">Estonia</option>
                <option value="68" title="Ethiopia" alt="Ethiopia">Ethiopia</option>
                <option value="69" title="Falkland Islands" alt="Falkland Islands">Falkland Islands</option>
                <option value="70" title="Faroe Islands" alt="Faroe Islands">Faroe Islands</option>
                <option value="71" title="Fiji" alt="Fiji">Fiji</option>
                <option value="72" title="Finland" alt="Finland">Finland</option>
                <option value="73" title="France" alt="France">France</option>
                <option value="74" title="French Guiana" alt="French Guiana">French Guiana</option>
                <option value="75" title="French Polynesia" alt="French Polynesia">French Polynesia</option>
                <option value="76" title="French Southern Territories" alt="French Southern Territories">French Southern Territories</option>
                <option value="77" title="Gabon" alt="Gabon">Gabon</option>
                <option value="78" title="Gambia" alt="Gambia">Gambia</option>
                <option value="79" title="Georgia" alt="Georgia">Georgia</option>
                <option value="80" title="Germany" alt="Germany">Germany</option>
                <option value="81" title="Ghana" alt="Ghana">Ghana</option>
                <option value="82" title="Gibraltar" alt="Gibraltar">Gibraltar</option>
                <option value="83" title="Greece" alt="Greece">Greece</option>
                <option value="84" title="Greenland" alt="Greenland">Greenland</option>
                <option value="85" title="Grenada" alt="Grenada">Grenada</option>
                <option value="86" title="Guadeloupe" alt="Guadeloupe">Guadeloupe</option>
                <option value="87" title="Guam" alt="Guam">Guam</option>
                <option value="88" title="Guatemala" alt="Guatemala">Guatemala</option>
                <option value="89" title="Guinea" alt="Guinea">Guinea</option>
                <option value="90" title="Guinea-Bissau" alt="Guinea-Bissau">Guinea-Bissau</option>
                <option value="91" title="Guyana" alt="Guyana">Guyana</option>
                <option value="92" title="Haiti" alt="Haiti">Haiti</option>
                <option value="93" title="Heard and McDonald Islands" alt="Heard and McDonald Islands">Heard and McDonald Islands</option>
                <option value="94" title="Honduras" alt="Honduras">Honduras</option>
                <option value="95" title="Hong Kong" alt="Hong Kong">Hong Kong</option>
                <option value="96" title="Hungary" alt="Hungary">Hungary</option>
                <option value="97" title="Iceland" alt="Iceland">Iceland</option>
                <option value="98" title="India" alt="India">India</option>
                <option value="99" title="Indonesia" alt="Indonesia">Indonesia</option>
                <option value="100" title="Iran" alt="Iran">Iran</option>
                <option value="101" title="Iraq" alt="Iraq">Iraq</option>
                <option value="102" title="Ireland" alt="Ireland">Ireland</option>
                <option value="103" title="Israel" alt="Israel">Israel</option>
                <option value="104" title="Italy" alt="Italy">Italy</option>
                <option value="105" title="Ivory Coast" alt="Ivory Coast">Ivory Coast</option>
                <option value="106" title="Jamaica" alt="Jamaica">Jamaica</option>
                <option value="107" title="Japan" alt="Japan">Japan</option>
                <option value="108" title="Jordan" alt="Jordan">Jordan</option>
                <option value="109" title="Kazakhstan" alt="Kazakhstan">Kazakhstan</option>
                <option value="110" title="Kenya" alt="Kenya">Kenya</option>
                <option value="111" title="Kiribati" alt="Kiribati">Kiribati</option>
                <option value="112" title="Korea, North" alt="Korea, North">Korea, North</option>
                <option value="113" title="Korea, South" alt="Korea, South">Korea, South</option>
                <option value="114" title="Kuwait" alt="Kuwait">Kuwait</option>
                <option value="115" title="Kyrgyzstan" alt="Kyrgyzstan">Kyrgyzstan</option>
                <option value="116" title="Laos" alt="Laos">Laos</option>
                <option value="117" title="Latvia" alt="Latvia">Latvia</option>
                <option value="118" title="Lebanon" alt="Lebanon">Lebanon</option>
                <option value="119" title="Lesotho" alt="Lesotho">Lesotho</option>
                <option value="120" title="Liberia" alt="Liberia">Liberia</option>
                <option value="121" title="Libya" alt="Libya">Libya</option>
                <option value="122" title="Liechtenstein" alt="Liechtenstein">Liechtenstein</option>
                <option value="123" title="Lithuania" alt="Lithuania">Lithuania</option>
                <option value="124" title="Luxembourg" alt="Luxembourg">Luxembourg</option>
                <option value="125" title="Macau" alt="Macau">Macau</option>
                <option value="126" title="Macedonia" alt="Macedonia">Macedonia</option>
                <option value="127" title="Madagascar" alt="Madagascar">Madagascar</option>
                <option value="128" title="Malawi" alt="Malawi">Malawi</option>
                <option value="129" title="Malaysia" alt="Malaysia">Malaysia</option>
                <option value="130" title="Maldives" alt="Maldives">Maldives</option>
                <option value="131" title="Mali" alt="Mali">Mali</option>
                <option value="132" title="Malta" alt="Malta">Malta</option>
                <option value="133" title="Marshall Islands" alt="Marshall Islands">Marshall Islands</option>
                <option value="134" title="Martinique" alt="Martinique">Martinique</option>
                <option value="135" title="Mauritania" alt="Mauritania">Mauritania</option>
                <option value="136" title="Mauritius" alt="Mauritius">Mauritius</option>
                <option value="137" title="Mayotte" alt="Mayotte">Mayotte</option>
                <option value="138" title="Mexico" alt="Mexico">Mexico</option>
                <option value="139" title="Micronesia" alt="Micronesia">Micronesia</option>
                <option value="140" title="Moldova" alt="Moldova">Moldova</option>
                <option value="141" title="Monaco" alt="Monaco">Monaco</option>
                <option value="142" title="Mongolia" alt="Mongolia">Mongolia</option>
                <option value="143" title="Montserrat" alt="Montserrat">Montserrat</option>
                <option value="144" title="Morocco" alt="Morocco">Morocco</option>
                <option value="145" title="Mozambique" alt="Mozambique">Mozambique</option>
                <option value="146" title="Myanmar" alt="Myanmar">Myanmar</option>
                <option value="147" title="Namibia" alt="Namibia">Namibia</option>
                <option value="148" title="Nauru" alt="Nauru">Nauru</option>
                <option value="149" title="Nepal" alt="Nepal">Nepal</option>
                <option value="150" title="Netherlands" alt="Netherlands">Netherlands</option>
                <option value="151" title="Netherlands Antilles" alt="Netherlands Antilles">Netherlands Antilles</option>
                <option value="152" title="New Caledonia" alt="New Caledonia">New Caledonia</option>
                <option value="153" title="New Zealand" alt="New Zealand">New Zealand</option>
                <option value="154" title="Nicaragua" alt="Nicaragua">Nicaragua</option>
                <option value="155" title="Niger" alt="Niger">Niger</option>
                <option value="156" title="Nigeria" alt="Nigeria">Nigeria</option>
                <option value="157" title="Niue" alt="Niue">Niue</option>
                <option value="158" title="Norfolk Island" alt="Norfolk Island">Norfolk Island</option>
                <option value="159" title="Northern Mariana Islands" alt="Northern Mariana Islands">Northern Mariana Islands</option>
                <option value="160" title="Norway" alt="Norway">Norway</option>
                <option value="161" title="Oman" alt="Oman">Oman</option>
                <option value="162" title="Pakistan" alt="Pakistan">Pakistan</option>
                <option value="163" title="Palau" alt="Palau">Palau</option>
                <option value="164" title="Panama" alt="Panama">Panama</option>
                <option value="165" title="Papua New Guinea" alt="Papua New Guinea">Papua New Guinea</option>
                <option value="166" title="Paraguay" alt="Paraguay">Paraguay</option>
                <option value="167" title="Peru" alt="Peru">Peru</option>
                <option value="168" title="Philippines" alt="Philippines">Philippines</option>
                <option value="169" title="Pitcairn Island" alt="Pitcairn Island">Pitcairn Island</option>
                <option value="170" title="Poland" alt="Poland">Poland</option>
                <option value="171" title="Portugal" alt="Portugal">Portugal</option>
                <option value="172" title="Puerto Rico" alt="Puerto Rico">Puerto Rico</option>
                <option value="173" title="Qatar" alt="Qatar">Qatar</option>
                <option value="174" title="Reunion" alt="Reunion">Reunion</option>
                <option value="175" title="Romania" alt="Romania">Romania</option>
                <option value="176" title="Russia" alt="Russia">Russia</option>
                <option value="177" title="Rwanda" alt="Rwanda">Rwanda</option>
                <option value="178" title="S. Georgia and S. Sandwich Isls." alt="S. Georgia and S. Sandwich Isls.">S. Georgia and S. Sandwich Isls.</option>
                <option value="179" title="Saint Kitts &amp; Nevis" alt="Saint Kitts &amp; Nevis">Saint Kitts &amp; Nevis</option>
                <option value="180" title="Saint Lucia" alt="Saint Lucia">Saint Lucia</option>
                <option value="181" title="Saint Vincent and The Grenadines" alt="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option>
                <option value="182" title="Samoa" alt="Samoa">Samoa</option>
                <option value="183" title="San Marino" alt="San Marino">San Marino</option>
                <option value="184" title="Sao Tome and Principe" alt="Sao Tome and Principe">Sao Tome and Principe</option>
                <option value="185" title="Saudi Arabia" alt="Saudi Arabia">Saudi Arabia</option>
                <option value="186" title="Senegal" alt="Senegal">Senegal</option>
                <option value="187" title="Seychelles" alt="Seychelles">Seychelles</option>
                <option value="188" title="Sierra Leone" alt="Sierra Leone">Sierra Leone</option>
                <option value="189" title="Singapore" alt="Singapore">Singapore</option>
                <option value="190" title="Slovakia" alt="Slovakia">Slovakia</option>
                <option value="191" title="Slovenia" alt="Slovenia">Slovenia</option>
                <option value="192" title="Somalia" alt="Somalia">Somalia</option>
                <option value="193" title="South Africa" alt="South Africa">South Africa</option>
                <option value="194" title="Spain" alt="Spain">Spain</option>
                <option value="195" title="Sri Lanka" alt="Sri Lanka">Sri Lanka</option>
                <option value="196" title="St. Helena" alt="St. Helena">St. Helena</option>
                <option value="197" title="St. Pierre and Miquelon" alt="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
                <option value="198" title="Sudan" alt="Sudan">Sudan</option>
                <option value="199" title="Suriname" alt="Suriname">Suriname</option>
                <option value="200" title="Svalbard and Jan Mayen Islands" alt="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
                <option value="201" title="Swaziland" alt="Swaziland">Swaziland</option>
                <option value="202" title="Sweden" alt="Sweden">Sweden</option>
                <option value="203" title="Switzerland" alt="Switzerland">Switzerland</option>
                <option value="204" title="Syria" alt="Syria">Syria</option>
                <option value="205" title="Taiwan" alt="Taiwan">Taiwan</option>
                <option value="206" title="Tajikistan" alt="Tajikistan">Tajikistan</option>
                <option value="207" title="Tanzania" alt="Tanzania">Tanzania</option>
                <option value="208" title="Thailand" alt="Thailand">Thailand</option>
                <option value="209" title="Togo" alt="Togo">Togo</option>
                <option value="210" title="Tokelau" alt="Tokelau">Tokelau</option>
                <option value="211" title="Tonga" alt="Tonga">Tonga</option>
                <option value="212" title="Trinidad and Tobago" alt="Trinidad and Tobago">Trinidad and Tobago</option>
                <option value="213" title="Tunisia" alt="Tunisia">Tunisia</option>
                <option value="214" title="Turkey" alt="Turkey">Turkey</option>
                <option value="215" title="Turkmenistan" alt="Turkmenistan">Turkmenistan</option>
                <option value="216" title="Turks and Caicos Islands" alt="Turks and Caicos Islands">Turks and Caicos Islands</option>
                <option value="217" title="Tuvalu" alt="Tuvalu">Tuvalu</option>
                <option value="218" title="Uganda" alt="Uganda">Uganda</option>
                <option value="219" title="Ukraine" alt="Ukraine">Ukraine</option>
                <option value="220" title="United Arab Emirates" alt="United Arab Emirates">United Arab Emirates</option>
                <option value="221" title="United Kingdom" alt="United Kingdom">United Kingdom</option>
                <option value="222" title="United States of America" alt="United States of America">United States of America</option>
                <option value="223" title="Uruguay" alt="Uruguay">Uruguay</option>
                <option value="224" title="Uzbekistan" alt="Uzbekistan">Uzbekistan</option>
                <option value="225" title="Vanuatu" alt="Vanuatu">Vanuatu</option>
                <option value="226" title="Vatican City" alt="Vatican City">Vatican City</option>
                <option value="227" title="Venezuela" alt="Venezuela">Venezuela</option>
                <option value="228" title="Vietnam" alt="Vietnam">Vietnam</option>
                <option value="229" title="Virgin Islands" alt="Virgin Islands">Virgin Islands</option>
                <option value="230" title="Wallis and Futuna Islands" alt="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
                <option value="231" title="Western Sahara" alt="Western Sahara">Western Sahara</option>
                <option value="232" title="Yemen" alt="Yemen">Yemen</option>
                <option value="233" title="Yugoslavia (Former)" alt="Yugoslavia (Former)">Yugoslavia (Former)</option>
                <option value="234" title="Zaire" alt="Zaire">Zaire</option>
                <option value="235" title="Zambia" alt="Zambia">Zambia</option>
                <option value="236" title="Zimbabwe" alt="Zimbabwe">Zimbabwe</option>
                <option value="237" title="Ashmore and Cartier Islands" alt="Ashmore and Cartier Islands">Ashmore and Cartier Islands</option>
                <option value="238" title="Solomon Islands" alt="Solomon Islands">Solomon Islands</option>
                <option value="239" title="Bassas da India" alt="Bassas da India">Bassas da India</option>
                <option value="240" title="Congo (Brazzaville)" alt="Congo (Brazzaville)">Congo (Brazzaville)</option>
                <option value="241" title="Coral Sea Islands" alt="Coral Sea Islands">Coral Sea Islands</option>
                <option value="243" title="Europa Island" alt="Europa Island">Europa Island</option>
                <option value="244" title="Guernsey" alt="Guernsey">Guernsey</option>
                <option value="245" title="Glorioso Islands" alt="Glorioso Islands">Glorioso Islands</option>
                <option value="246" title="Gaza Strip" alt="Gaza Strip">Gaza Strip</option>
                <option value="247" title="Isle of Man" alt="Isle of Man">Isle of Man</option>
                <option value="248" title="Clipperton Island" alt="Clipperton Island">Clipperton Island</option>
                <option value="249" title="Cote DIvoire" alt="Cote DIvoire">Cote DIvoire</option>
                <option value="250" title="Jersey" alt="Jersey">Jersey</option>
                <option value="251" title="Jan Mayen" alt="Jan Mayen">Jan Mayen</option>
                <option value="252" title="Juan de Nova Island" alt="Juan de Nova Island">Juan de Nova Island</option>
                <option value="253" title="Macedonia" alt="Macedonia">Macedonia</option>
                <option value="254" title="Bodies of water" alt="Bodies of water">Bodies of water</option>
                <option value="255" title="Paracel Islands" alt="Paracel Islands">Paracel Islands</option>
                <option value="256" title="Spratly Islands" alt="Spratly Islands">Spratly Islands</option>
                <option value="257" title="Saint Pierre and Miquelon" alt="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
                <option value="258" title="Saint Helena" alt="Saint Helena">Saint Helena</option>
                <option value="259" title="Svalbard" alt="Svalbard">Svalbard</option>
                <option value="260" title="Tromelin Island" alt="Tromelin Island">Tromelin Island</option>
                <option value="261" title="Undersea features" alt="Undersea features">Undersea features</option>
                <option value="262" title="Saint Vincent &amp; the Grenadines" alt="Saint Vincent &amp; the Grenadines">Saint Vincent &amp; the Grenadines</option>
                <option value="263" title="West Bank" alt="West Bank">West Bank</option>
                <option value="264" title="Wallis and Futuna" alt="Wallis and Futuna">Wallis and Futuna</option>
                <option value="265" title="Serbia and Montenegro" alt="Serbia and Montenegro">Serbia and Montenegro</option>-->
              </select>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
		  
		  <!-- STATE -->
		  <dl id="stateDiv">
            <dt>
              <label for="State" style="display:block; padding:0px 0px 5px 0px">Residing State <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <select onchange="selectSateCode(this.value);" name="residingState" id="residingState" class="txtBox input" style="width:176px;">
              <option value="0">--Select--</option>
              <!--  <option value="0">--Select--</option>
                <option value="1">Andaman &amp; Nicobar</option>
                <option value="2">Andhra Pradesh</option>
                <option value="3">Arunachal Pradesh</option>
                <option value="4">Assam</option>
                <option value="5">Bihar</option>
                <option value="6">Chandigarh</option>
                <option value="7">Chhattisgarh</option>
                <option value="8">Dadra &amp; Nagar Haveli</option>
                <option value="9">Daman &amp; Diu</option>
                <option value="10">Delhi</option>
                <option value="11">Goa</option>
                <option value="12">Gujarat</option>
                <option value="13">Haryana</option>
                <option value="14">Himachal Pradesh</option>
                <option value="15">Jammu &amp; Kashmir</option>
                <option value="16">Jharkand</option>
                <option value="17">Karnataka</option>
                <option value="18" selected="">Kerala</option>
                <option value="19">Lakshadeep</option>
                <option value="20">Madhya Pradesh</option>
                <option value="21">Maharashtra</option>
                <option value="22">Manipur</option>
                <option value="23">Meghalaya</option>
                <option value="24">Mizoram</option>
                <option value="25">Nagaland</option>
                <option value="26">Odisha</option>
                <option value="27">Pondicherry</option>
                <option value="28">Punjab</option>
                <option value="29">Rajasthan</option>
                <option value="30">Sikkim</option>
                <option value="31">Tamil Nadu</option>
                <option value="32">Tripura</option>
                <option value="33">Uttar Pradesh</option>
                <option value="34">Uttaranchal</option>
                <option value="35">West Bengal</option>-->
              </select>
              <div id="residingStateSpan" class="error"></div>
              <input type="hidden" name="stateOption" id="stateOption" value="35">
            </dd>
          </dl>
		  <!-- STATE -->
		   <dl id="cityDiv">
            <dt>
              <label for="State" style="display:block; padding:0px 0px 5px 0px">Residing City/District <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <select name="residingCity" id="residingCity" class="txtBox input" style="width:176px;">
              <option value="0">--Select--</option>
              <!--  <option value="0">--Select--</option>
                <option value="248">Thiruvananthapuram</option>
                <option value="249">Alappuzha</option>
                <option value="250">Ernakulam</option>
                <option value="251">Idukki</option>
                <option value="252">Kannur</option>
                <option value="253">Kasargod</option>
                <option value="254">Kollam</option>
                <option value="255">Kottayam</option>
                <option value="256">Kozhikode</option>
                <option value="257">Malappuram</option>
                <option value="258">Palakkad</option>
                <option value="259">Pathanamthitta</option>
                <option value="260" selected="">Thrissur</option>
                <option value="261">Wayanad</option>-->
              </select>
              <input type="hidden" name="cityOption" id="cityOption" value="14">
              <div id="residingCitySpan" class="error"></div>
            </dd>
          </dl>
          <dl class="dotted">
		  <!-- EDUCATION-->
		   <dl>
              <dt>
                <label for="educationCategory" style="display:block; padding:3px 0px 4px 0px;"> Highest Education  <span class="rdclr">*</span></label>
              </dt>
              <dd>
                <select name="education" id="educationCategory"  class="txtBox input" tabindex="1" style="width:176px;">
                  <optgroup label="Bachelors - Engineering / Computers / Others">
                  <option value="5">BCA</option>
                  <option value="6">Aeronautical Engineering</option>
                  <option value="8">B Arch</option>
                  <option value="9">B Plan</option>
                  <option value="49">BE</option>
                  <option selected="selected" value="50">B Tech</option>
                  <option value="83">Other Bachelor Degree</option>
                  <option value="95">BSc IT / Computer Science</option>
                  </optgroup>
                  <optgroup label="Masters - Engineering / Computers / Others">
                  <option value="3">MS (Engg.)</option>
                  <option value="7">M Arch</option>
                  <option value="51">MCA</option>
                  <option value="52">PGDCA</option>
                  <option value="53">ME</option>
                  <option value="54">M Tech</option>
                  <option value="55">MSc IT / Computer Science</option>
                  <option value="84">Other Master Degree</option>
                  </optgroup>
                  <optgroup label="Bachelors - Arts / Science / Commerce / Others">
                  <option value="15">B Phil</option>
                  <option value="16">BCom</option>
                  <option value="17">BSc</option>
                  <option value="18">BA</option>
                  <option value="39">B Ed</option>
                  <option value="43">Aviation Degree</option>
                  <option value="56">BFA</option>
                  <option value="57">BLIS</option>
                  <option value="58">BSW</option>
                  <option value="59">BMM (MASS MEDIA)</option>
                  <option value="66">BFT</option>
                  <option value="85">Other Bachelor Degree</option>
                  </optgroup>
                  <optgroup label="Masters - Arts / Science / Commerce / Others">
                  <option value="10">M Phil</option>
                  <option value="11">M Com</option>
                  <option value="12">M Sc</option>
                  <option value="13">MA</option>
                  <option value="38">M Ed</option>
                  <option value="60">MLIS</option>
                  <option value="63">MSW</option>
                  <option value="86">Other Master Degree</option>
                  </optgroup>
                  <optgroup label="Bachelors - Management / Others">
                  <option value="19">BHM</option>
                  <option value="35">BBA</option>
                  <option value="65">BFM (Financial Management)</option>
                  <option value="87">Other Bachelor Degree in Management</option>
                  </optgroup>
                  <optgroup label="Masters - Management / Others">
                  <option value="14">MHM</option>
                  <option value="61">MBA</option>
                  <option value="62">PGDM</option>
                  <option value="64">MHRM (Human Resource Management)</option>
                  <option value="76">MFM (Financial Management)</option>
                  <option value="96">Other Master Degree  in Management</option>
                  </optgroup>
                  <optgroup label="Bachelors - Medicine - General / Dental / Surgeon / Others">
                  <option value="21">MBBS</option>
                  <option value="25">BDS</option>
                  <option value="27">BPT</option>
                  <option value="28">BHMS</option>
                  <option value="29">BAMS</option>
                  <option value="31">B Pharm</option>
                  <option value="68">BSMS</option>
                  <option value="69">BUMS</option>
                  <option value="88">Other Bachelor Degree in Medicine</option>
                  </optgroup>
                  <optgroup label="Masters - Medicine - General / Dental / Surgeon / Others">
                  <option value="20">MD / MS (Medical)</option>
                  <option value="22">MDS</option>
                  <option value="23">MVSc </option>
                  <option value="24">MPT</option>
                  <option value="97">Other Master Degree in Medicine</option>
                  </optgroup>
                  <optgroup label="Bachelors - Legal / Others">
                  <option value="72">BGL</option>
                  <option value="73">BL</option>
                  <option value="74">LLB</option>
                  <option value="90">Other Bachelor Degree in Legal</option>
                  </optgroup>
                  <optgroup label="Masters - Legal / Others">
                  <option value="70">ML</option>
                  <option value="71">LLM</option>
                  <option value="89">Other Master Degree in  Legal</option>
                  </optgroup>
                  <optgroup label="Finance - ICWAI / CA / CS/ CFA / Others">
                  <option value="36">CA</option>
                  <option value="37">ICWA</option>
                  <option value="48">CS</option>
                  <option value="75">CFA (Chartered Financial Analyst)</option>
                  <option value="91">Other Degree in Finance</option>
                  </optgroup>
                  <optgroup label="Service - IAS / IPS / IRS / IES / IFS / Others">
                  <option value="77">IAS</option>
                  <option value="78">IPS</option>
                  <option value="79">IRS</option>
                  <option value="80">IES</option>
                  <option value="81">IFS</option>
                  <option value="92">Other Degree in Service</option>
                  </optgroup>
                  <optgroup label="PhD">
                  <option value="33">Ph D</option>
                  </optgroup>
                  <optgroup label="Diploma / Others">
                  <option value="45">Trade School</option>
                  <option value="46">Diploma</option>
                  <option value="82">Polytechnic</option>
                  </optgroup>
                  <optgroup label="Higher Secondary / Secondary">
                  <option value="47">High School</option>
                  </optgroup>
                </select>
                <div id="educationCategorySpan" class="error"></div>
              </dd>
            </dl>
            <dl class="dotted">
		   <!-- Occupation -->
            <dl>
              <dt>
                <label for="occupation" style="display:block; padding:3px 0px 4px 0px;"> Occupation <span class="rdclr">*</span> </label>
              </dt>
              <dd>
                <select name="occupation" id="occupation" class="txtBox input" tabindex="9" style="width:176px;">
                  <option value="0">-- Select --</option>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- ADMIN --">
                  <option value="49">Manager</option>
                  <option value="48">Supervisor</option>
                  <option value="47">Officer</option>
                  <option value="39">Administrative Professional</option>
                  <option value="50">Executive</option>
                  <option value="46">Clerk</option>
                  <option value="63">Human Resources Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- AGRICULTURE --">
                  <option value="37">Agriculture &amp; Farming Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- AIRLINE --">
                  <option value="30">Pilot</option>
                  <option value="28">Air Hostess</option>
                  <option value="29">Airline Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- ARCHITECT &amp; DESIGN --">
                  <option value="19">Architect</option>
                  <option value="20">Interior Designer</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- BANKING &amp; FINANCE --">
                  <option value="7">Chartered Accountant</option>
                  <option value="10">Company Secretary</option>
                  <option value="8">Accounts / Finance Professional</option>
                  <option value="16">Banking Service Professional</option>
                  <option value="9">Auditor</option>
                  <option value="64">Financial Analyst / Planning</option>
                  <option value="69">Financial Accountant</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- BEAUTY &amp; FASHION --">
                  <option value="25">Fashion Designer</option>
                  <option value="33">Beautician</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- CIVIL SERVICES --">
                  <option value="52">Civil Services (IAS/IPS/IRS/IES/IFS)</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- DEFENCE --">
                  <option value="53">Army</option>
                  <option value="54">Navy</option>
                  <option value="55">Airforce</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- EDUCATION --">
                  <option value="5">Professor / Lecturer</option>
                  <option value="4">Teaching / Academician</option>
                  <option value="6">Education Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- HOSPITALITY --">
                  <option value="34">Hotel / Hospitality Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- IT &amp; ENGINEERING --">
                  <option value="1" selected="">Software Professional</option>
                  <option value="2">Hardware Professional</option>
                  <option value="3">Engineer - Non IT</option>
                  <option value="65">Designer</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- LEGAL --">
                  <option value="17">Lawyer &amp; Legal Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- LAW ENFORCEMENT  --">
                  <option value="18">Law Enforcement Officer</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- MEDICAL --">
                  <option value="12">Doctor</option>
                  <option value="14">Health Care Professional</option>
                  <option value="15">Paramedical Professional</option>
                  <option value="13">Nurse</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- MARKETING &amp; SALES --">
                  <option value="42">Marketing Professional</option>
                  <option value="43">Sales Professional</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- MEDIA &amp; ENTERTAINMENT --">
                  <option value="27">Journalist</option>
                  <option value="22">Media Professional</option>
                  <option value="24">Entertainment Professional</option>
                  <option value="26">Event Management Professional</option>
                  <option value="21">Advertising / PR Professional</option>
                  <option value="66">Designer</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- MERCHANT NAVY --">
                  <option value="32">Mariner / Merchant Navy</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- SCIENTIST --">
                  <option value="35">Scientist / Researcher</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- TOP MANAGEMENT --">
                  <option value="41">CXO / President, Director, Chairman</option>
                  <option value="70">Business Analyst</option>
                  </optgroup>
                  <optgroup label="&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;-- OTHERS --">
                  <option value="45">Consultant</option>
                  <option value="40">Customer Care Professional</option>
                  <option value="36">Social Worker</option>
                  <option value="51">Sportsman</option>
                  <option value="44">Technician</option>
                  <option value="38">Arts &amp; Craftsman</option>
                  <option value="67">Student</option>
                  <option value="68">Librarian</option>
                  </optgroup>
                </select>
                <div id="occupationSpan" class="error"></div>
              </dd>
            </dl>
            <dl class="dotted">	
          <!-- Mobile  -->
          <dl>
            <dt class="frmlabel">
              <label for="">Mobile Number <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <select id="mob_countrycode" name="mob_countrycode" size="1" tabindex="26" style="width:102px;">
                <option value="0">--- Select ---</option>
                <option value="98">India (91)</option>
                <option value="222">United States of America (1)</option>
                <option value="220">United Arab Emirates (971)</option>
                <option value="129">Malaysia (60)</option>
                <option value="221">United Kingdom (44)</option>
                <option value="13">Australia (61)</option>
                <option value="185">Saudi Arabia (966)</option>
                <option value="39">Canada (1)</option>
                <option value="189">Singapore (65)</option>
                <option value="114">Kuwait (965)</option>
                <option value="">-----------------------------</option>
                <option value="1">Afghanistan (93)</option>
                <option value="2">Albania (355)</option>
                <option value="3">Algeria (213)</option>
                <option value="4">American Samoa (684)</option>
                <option value="5">Andorra (376)</option>
                <option value="6">Angola (244)</option>
                <option value="7">Anguilla (1264)</option>
                <option value="8">Antarctica (672)</option>
                <option value="9">Antigua and Barbuda (1268)</option>
                <option value="10">Argentina (54)</option>
                <option value="11">Armenia (374)</option>
                <option value="12">Aruba (297)</option>
                <option value="13">Australia (61)</option>
                <option value="14">Austria (43)</option>
                <option value="15">Azerbaijan (994)</option>
                <option value="16">Bahamas (1242)</option>
                <option value="17">Bahrain (973)</option>
                <option value="18">Bangladesh (880)</option>
                <option value="19">Barbados (246)</option>
                <option value="20">Belarus (375)</option>
                <option value="21">Belgium (32)</option>
                <option value="22">Belize (501)</option>
                <option value="23">Benin (229)</option>
                <option value="24">Bermuda (441)</option>
                <option value="25">Bhutan (975)</option>
                <option value="26">Bolivia (591)</option>
                <option value="27">Bosnia and Herzegovina (387)</option>
                <option value="28">Botswana (267)</option>
                <option value="30">Brazil (55)</option>
                <option value="32">British Virgin Islands (284)</option>
                <option value="33">Brunei (673)</option>
                <option value="34">Bulgaria (359)</option>
                <option value="35">Burkina Faso (226)</option>
                <option value="36">Burundi (257)</option>
                <option value="37">Cambodia (855)</option>
                <option value="38">Cameroon (237)</option>
                <option value="40">Cape Verde (238)</option>
                <option value="41">Cayman Islands (345)</option>
                <option value="42">Central African Republic (236)</option>
                <option value="43">Chad (235)</option>
                <option value="44">Chile (56)</option>
                <option value="45">China (86)</option>
                <option value="46">Christmas Island (672)</option>
                <option value="47">Cocos Islands (672)</option>
                <option value="48">Colombia (57)</option>
                <option value="49">Comoros (269)</option>
                <option value="50">Congo (242)</option>
                <option value="51">Cook Islands (682)</option>
                <option value="52">Costa Rica (506)</option>
                <option value="53">Croatia (385)</option>
                <option value="54">Cuba (53)</option>
                <option value="55">Cyprus (357)</option>
                <option value="56">Czech Republic (420)</option>
                <option value="57">Denmark (45)</option>
                <option value="58">Djibouti (253)</option>
                <option value="59">Dominica (767)</option>
                <option value="60">Dominican Republic (809)</option>
                <option value="61">East Timor (670)</option>
                <option value="62">Ecuador (593)</option>
                <option value="63">Egypt (20)</option>
                <option value="64">El Salvador (503)</option>
                <option value="65">Equatorial Guinea (240)</option>
                <option value="66">Eritrea (291)</option>
                <option value="67">Estonia (372)</option>
                <option value="68">Ethiopia (251)</option>
                <option value="69">Falkland Islands (500)</option>
                <option value="70">Faroe Islands (298)</option>
                <option value="71">Fiji (679)</option>
                <option value="72">Finland (358)</option>
                <option value="73">France (33)</option>
                <option value="74">French Guiana (594)</option>
                <option value="75">French Polynesia (689)</option>
                <option value="77">Gabon (241)</option>
                <option value="78">Gambia (220)</option>
                <option value="79">Georgia (995)</option>
                <option value="80">Germany (49)</option>
                <option value="81">Ghana (223)</option>
                <option value="82">Gibraltar (350)</option>
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                <option value="84">Greenland (299)</option>
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                <option value="86">Guadeloupe (590)</option>
                <option value="87">Guam (671)</option>
                <option value="88">Guatemala (502)</option>
                <option value="89">Guinea (224)</option>
                <option value="90">Guinea-Bissau (245)</option>
                <option value="91">Guyana (592)</option>
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                <option value="94">Honduras (504)</option>
                <option value="95">Hong Kong (852)</option>
                <option value="96">Hungary (36)</option>
                <option value="97">Iceland (354)</option>
                <option value="98">India (91)</option>
                <option value="99">Indonesia (62)</option>
                <option value="100">Iran (98)</option>
                <option value="101">Iraq (964)</option>
                <option value="102">Ireland (353)</option>
                <option value="103">Israel (972)</option>
                <option value="104">Italy (39)</option>
                <option value="106">Jamaica (876)</option>
                <option value="107">Japan (81)</option>
                <option value="108">Jordan (962)</option>
                <option value="109">Kazakhstan (7)</option>
                <option value="110">Kenya (254)</option>
                <option value="111">Kiribati (686)</option>
                <option value="112">Korea, North (82)</option>
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                <option value="114">Kuwait (965)</option>
                <option value="115">Kyrgyzstan (996)</option>
                <option value="116">Laos (856)</option>
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                <option value="133">Marshall Islands (692)</option>
                <option value="134">Martinique (596)</option>
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                <option value="137">Mayotte (269)</option>
                <option value="138">Mexico (52)</option>
                <option value="139">Micronesia (691)</option>
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                <option value="141">Monaco (377)</option>
                <option value="142">Mongolia (976)</option>
                <option value="143">Montserrat (664)</option>
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                <option value="146">Myanmar (95)</option>
                <option value="147">Namibia (264)</option>
                <option value="148">Nauru (674)</option>
                <option value="149">Nepal (977)</option>
                <option value="150">Netherlands (31)</option>
                <option value="151">Netherlands Antilles (599)</option>
                <option value="152">New Caledonia (687)</option>
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                <option value="157">Niue (683)</option>
                <option value="159">Northern Mariana Islands (1670)</option>
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                <option value="161">Oman (968)</option>
                <option value="162">Pakistan (92)</option>
                <option value="163">Palau (680)</option>
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                <option value="165">Papua New Guinea (675)</option>
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                <option value="171">Portugal (351)</option>
                <option value="172">Puerto Rico (787)</option>
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                <option value="179">Saint Kitts &amp; Nevis (869)</option>
                <option value="180">Saint Lucia (758)</option>
                <option value="181">Saint Vincent and The Grenadines (784)</option>
                <option value="182">Samoa (685)</option>
                <option value="183">San Marino (378)</option>
                <option value="184">Sao Tome and Principe (239)</option>
                <option value="185">Saudi Arabia (966)</option>
                <option value="186">Senegal (221)</option>
                <option value="187">Seychelles (248)</option>
                <option value="188">Sierra Leone (232)</option>
                <option value="189">Singapore (65)</option>
                <option value="190">Slovakia (421)</option>
                <option value="191">Slovenia (386)</option>
                <option value="192">Somalia (252)</option>
                <option value="193">South Africa (27)</option>
                <option value="194">Spain (34)</option>
                <option value="195">Sri Lanka (94)</option>
                <option value="198">Sudan (249)</option>
                <option value="199">Suriname (597)</option>
                <option value="201">Swaziland (268)</option>
                <option value="202">Sweden (46)</option>
                <option value="203">Switzerland (41)</option>
                <option value="204">Syria (963)</option>
                <option value="206">Tajikistan (992)</option>
                <option value="207">Tanzania (255)</option>
                <option value="208">Thailand (66)</option>
                <option value="209">Togo (228)</option>
                <option value="210">Tokelau (690)</option>
                <option value="211">Tonga (676)</option>
                <option value="212">Trinidad and Tobago (868)</option>
                <option value="213">Tunisia (216)</option>
                <option value="214">Turkey (90)</option>
                <option value="215">Turkmenistan (993)</option>
                <option value="216">Turks and Caicos Islands (649)</option>
                <option value="217">Tuvalu (688)</option>
                <option value="218">Uganda (256)</option>
                <option value="219">Ukraine (380)</option>
                <option value="220">United Arab Emirates (971)</option>
                <option value="221">United Kingdom (44)</option>
                <option value="222">United States of America (1)</option>
                <option value="223">Uruguay (598)</option>
                <option value="224">Uzbekistan (998)</option>
                <option value="225">Vanuatu (678)</option>
                <option value="226">Vatican City (379)</option>
                <option value="227">Venezuela (58)</option>
                <option value="228">Vietnam (84)</option>
                <option value="230">Wallis and Futuna Islands (681)</option>
                <option value="232">Yemen (967)</option>
                <option value="233">Yugoslavia (Former) (381)</option>
                <option value="235">Zambia (260)</option>
                <option value="236">Zimbabwe (263)</option>
              </select>
              &nbsp;&nbsp;
              <input type="text" maxlength="40" class="input" value="<?php echo $mob_phone;?>" name="mob_phone" id="mob_phone" style="width:167px;" tabindex="27" >
              <input type="hidden" id="prvMobileNo" name="prvMobileNo" value="">
              <div id="emailexist" style="padding-left:150px;" class="error"><?php echo $error_mob_phone;?></div>
              <div>
                <!-- <div class="error padr5" style="float:left;">Please enter the mobile number</div> -->
                <div id="mobileMsg" class="error" style="float:left;display:none;color:green;">You will receive a PIN number from us via SMS to verify this mobile number </div>
                <div class="cleard">
                  <!--  -->
                </div>
              </div>
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- E-mail  -->
          <dl>
            <dt class="frmlabel">
              <label for="">E-mail <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <input type="text" maxlength="40" class="input" value="<?php echo $email;?>" name="email" id="email"  tabindex="28" style="width:167px;">
            </dd>
            <div id="emailexist" style="padding-left:150px;" class="error"><?php echo $error_email;?></div>
            <input type="hidden" id="prvEmail" name="prvEmail" value="">
            <input type="hidden" id="prvEmailStatus" name="prvEmailStatus" value="0">
          </dl>
          <dl class="dotted">
          </dl>
          <!-- Password  -->
          <dl>
            <dt class="frmlabel">
              <label for="">Password <span class="rdclr">*</span></label>
            </dt>
            <dd>
              <input type="password" value="" name="password" id="password" onfocus="toolTipFocus('password',varTtip['password']);" onblur="toolTipBlur();" tabindex="29" style="width:167px;" class="input" maxlength="20">
            </dd>
          </dl>
          <dl class="dotted">
          </dl>
          <!-- Terms and Conditions  -->
          <div style="width:550px; padding-top:25px;">
            <div class="fleft smalltxt clr7 padt7" style="width:auto;"><span>
              <input type="checkbox" name="termsAndConditions" id="termsAndConditions" value="1" checked="checked" tabindex="30">
              </span><span class="padl10">
              <label class="radiolabel" for="termsAndConditions" id="">I accept the <a target="_blank" href="#" style="text-decoration:none;" class="linkb">Privacy Policy</a> &amp; <a target="_blank" href="#" style="text-decoration:none;" class="linkb">Terms and Conditions</a></label>
              </span><span id="terms"></span></div>
            <div class="fright" style="text-align:right;width:167px;">
              <input style="text-transform:none;" type="submit" value="Quick Register" name="register" id="" size="38" class="btnbig width170" tabindex="31">
            </div>
            <div class="clear">
              <!-- -->
            </div>
          </div>
        </form>
      </div>
    </div>
    <!-- Form Ends -->
  </div>
  <div class="fright" id="rp" style="width:290px;">
    <div class="box1">
      <div style="padding:6px;">
        <div style="clear:both;"></div>
        <div class="hdot1">
          <!-- -->
        </div>
      </div>
    </div>
    <br>
    <div class="box1">
      <div style="padding:6px;"></div>
    </div>
    <br>
    <div class="box1">
      <div style="padding:20px 6px 10px 6px;">
        <ul>
          <li class="india">INDIA : 0 - 814 - 477 - 8866</li>
          <li class="usa">USA : 818 - 338 - 0015</li>
          <li class="uk">UK : 0 - 800 - 635 - 0674</li>
          <li class="uae">UAE : 971 - 4383 - 1000</li>
          <li class="others clr1">Other Countries : 91 - 44 - 39115022</li>
        </ul>
        <center>
          <div class="smalltxt" style="line-height:16px;text-align:center;border:1px solid #FFF;padding:5px;width:245px;margin:0px auto;">For payment related queries,<br>
            Call Toll Free No. 1-800-3000-4466. (India)</div>
        </center>
      </div>
    </div>
    <br>
  </div>
  <div class="clear">
    <!-- -->
  </div>
  <div class="clear padt15">
    <!-- -->
  </div>
  <div class="clear padb15">
    <!-- -->
  </div>
  <div id="fade" class="bgfadediv"></div>
  <!-- Tool Tip -->
  <div id="tip_align"> <span id="tip_name" class="hidespan">
    <div class="tooltip-arrow"></div>
    <div class="tooltip-inner">
      <div class="tooltip-topcurve">
        <div class="tooltip-bottomcurve">
          <div id="tip_name_txt" class="tooltip-txt" style="width:162px;"></div>
        </div>
      </div>
    </div>
    </span> </div>
</div>
